{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:32Z","timestamp":1760146292595,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Contralateral A1 and AComA aplasia\/hypoplasia are critically important in distal ICA T occlusion as the protective collateral blood supply from the circle of Willis via the anterior communicating artery is compromised. Although the terms aplasia\/hypoplasia are used broadly in the literature, the need for concrete measurements and data on their clinical significance is apparent. Features of the individual anatomy of the circle of Willis may determine patient outcomes. We aim to determine the cut-off values of contralateral A1 and AComA segments that determine worse outcomes for patients with acute ischemic stroke with T occlusion of the terminal internal carotid artery. Material and Methods: Retrospective patient data from 2015 to 2020 and prospective data from 2021 to 2022 of 482 patients with diagnosed acute ischemic stroke that underwent mechanical thrombectomy at the Republican Vilnius University Hospital (Vilnius, Lithuania) were obtained. Of these patients, 70 were selected with occlusion of internal carotid artery bifurcation and extension to M1 or A1 segments. For statistically significant interactions, patient data were analyzed using two statistical methods (logistic regression and Multivariate Adaptive Regression Splines (MARS)). Results: The narrowest segment of contralateral A1 and\/or AComA was statistically significant for 7-day NIHSS, and the optimal cut-off points for this variable were 1.1 mm (MARS model) and 1.2 mm (logistic regression, p = 0.0079, sensitivity 66.7%, specificity 67.9%). The other considered variables (age, gender, time from last seen well to groin puncture, intravenous recombinant tissue plasminogen activator, admission NIHSS, and ASPECT score) and their interactions were not statistically significant. Conclusions: A negative correlation was found between the narrowest segment and seven days of NIHSS. A larger diameter of contralateral A1 and AComA appears to be essential for better patient outcomes at 7-day evaluation post mechanical thrombectomy.<\/jats:p>","DOI":"10.3390\/medicina60111749","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T09:11:47Z","timestamp":1729761107000},"page":"1749","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Narrow Anterior Communicating Artery or Contralateral A1 Segment with Poor Outcomes After Mechanical Thrombectomy"],"prefix":"10.3390","volume":"60","author":[{"given":"Audrius","family":"\u0160irvinskas","sequence":"first","affiliation":[{"name":"Department of Radiology, Republican Vilnius University Hospital, \u0160iltnami\u0173 g. 29, 04130 Vilnius, Lithuania"},{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giedrius","family":"Ledas","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6911-5653","authenticated-orcid":false,"given":"R\u016bta","family":"Levulien\u0117","sequence":"additional","affiliation":[{"name":"Institute of Applied Mathematics, Vilnius University, 03225 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurgita","family":"Markevi\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"Institute of Applied Mathematics, Vilnius University, 03225 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3783-3121","authenticated-orcid":false,"given":"Valerija","family":"Mosenko","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrej","family":"Afanasjev","sequence":"additional","affiliation":[{"name":"Department of Radiology, Republican Vilnius University Hospital, \u0160iltnami\u0173 g. 29, 04130 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8055-3558","authenticated-orcid":false,"given":"Aleksandras","family":"Vilionskis","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 04130 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-4737","authenticated-orcid":false,"given":"Saulius","family":"Luko\u0161evi\u010dius","sequence":"additional","affiliation":[{"name":"Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Algirdas Edvardas","family":"Tamo\u0161i\u016bnas","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","first-page":"w14538","article-title":"Relevance of the cerebral collateral circulation in ischaemic stroke: Time is the brain, but collaterals set the pace","volume":"147","author":"Jung","year":"2017","journal-title":"Swiss Med. 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